FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 05/31/2006 |
3. Issuer Name and Ticker or Trading Symbol
CTC Media, Inc. [ CTCM ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 31,839,200 | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Class A Senior Preferred Stock | (1) | (2) | Common Stock | 26,489,600 | (3) | D | |
Super Senior Preferred Stock | (1) | (2) | Common Stock | 1,680,000 | (3) | D |
Explanation of Responses: |
1. Immediately prior to the initial public offering of the Issuer's Common Stock, each outstanding share of Preferred Stock will be automatically converted into 800 shares of the Issuer's Common Stock. |
2. Not applicable. |
3. Immediately prior to the initial public offering of the Issuer's Common Stock, each outstanding share of Preferred Stock will be automatically converted into 800 shares of the Issuer's Common Stock. |
Remarks: |
Pursuant to an amended stockholders agreement among MTG Broadcasting AB, the Issuer and other stockholders of the Issuer, MTG is entitled to designate three individuals for election to the board of directors of the Issuer. |
/s/ Hans-Holger Albrecht and Anders Nilsson, board members | 05/31/2006 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |